Healthcare Provider Details

I. General information

NPI: 1811634728
Provider Name (Legal Business Name): EMMA ZUCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 5TH AVE RM 1606
NEW YORK NY
10016-6649
US

IV. Provider business mailing address

303 5TH AVE RM 1606
NEW YORK NY
10016-6649
US

V. Phone/Fax

Practice location:
  • Phone: 908-510-4888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: